26605 Enterovirus, Molecular Detection, PCR, Varies (LENT)

​Coxsackievirus; Coxsackievirus A; Coxsackievirus B; Echovirus; Enterovirus; Enterovirus (Coxsackievirus and Echovirus); Hand, Foot, and Mouth Disease​

​Aiding in diagnosing enterovirus infections

This test should not be used to screen asymptomatic patients

​Ordering Guidance: This test will detect enterovirus but will not differentiate viruses in this family or provide serotyping information.

Necessary Information: Specimen source is required. Source information should include main anatomical site of collection.

Submit a raw clinical sample (not a culture isolate) for enterovirus testing.​

Collection Instructions:

• Body fluid: Do not centrifuge. 
  
• Spinal fluid: Submit specimen from collection vial 2. Do not centrifuge.
  
• Swab: Rectal swab must have no visible fecal matter. Place swab back into multimicrobe media (M4-RT, M4, or M5).
  
• Respiratory: Do not centrifuge
  

​A negative result does not rule out the possibility of enterovirus infection.

This assay may detect virus from a variety of specimen types in asymptomatic individuals, including feces. This assay should only be used for patients with a clinical history and symptoms consistent with enterovirus infection and must be interpreted in the context of the clinical picture.

This is a qualitative assay. Results are reported as either negative or positive for targeted enterovirus RNA.

​Enteroviruses are positive-sense RNA viruses in the Picornaviridae family. These viruses were initially classified by serotype as polioviruses (3 types), echoviruses (31 types, including types 22 and 23, which are now classified as parechoviruses), coxsackievirus A (23 types), and coxsackievirus B (6 types). However, genomic studies have demonstrated that there is significant overlap in the biological characteristics of different serotypes and more recently isolated enteroviruses are now named with consecutive numbers (eg, EV68, EV69).

The normal site of enterovirus replication is the gastrointestinal tract where the infection is typically subclinical. However, in a proportion of cases, the virus spreads to other organs, causing systemic manifestations, including mild respiratory disease (eg, the common cold); conjunctivitis; hand, foot, and mouth disease; aseptic meningitis; myocarditis; and acute flaccid paralysis. Collectively, enteroviruses are the most common cause of upper respiratory tract disease in children. In addition, the enteroviruses are the most common cause of central nervous system (CNS) disease; they account for almost all viruses recovered in culture from spinal fluid. Differentiation of enteroviruses from other viruses and bacteria that cause CNS disease is important for the appropriate medical management of these patients.

Traditional cell culture methods require 6 days, on average, for enterovirus detection. In comparison, real-time polymerase chain reaction (PCR) allows same-day detection. Detection of enterovirus nucleic acid by PCR is also the most sensitive diagnostic method for the diagnosis of CNS infection caused by these viruses.

​A positive result indicates the presence of enterovirus RNA in the specimen.